Open AccessColon cancer modulation by a diabetic environment: A single institutional experience
Author(s) -
I. Prieto,
Laura del PuertoNevado,
Nieves González,
Sergio PortalNúñez,
Sandra Zazo,
Marta Cortón,
Pablo Mínguez,
Carmen Gómez-Guerrero,
José Miguel Sahuquillo Arce,
Ana B. Sanz,
Sebastián Más,
Óscar Aguilera,
Gloria Alvarez-Llamas,
Pedro Esbrit,
Alberto Ortíz,
Carmen Ayuso,
Jesús Egido,
Federico Rojo,
Jesús GarcíaFoncillas
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0172300
Subject(s) - medicine , colorectal cancer , diabetes mellitus , cancer , lymphovascular invasion , oncology , metformin , retrospective cohort study , adjuvant therapy , gastroenterology , metastasis , endocrinology
Background Multiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior. Aim To gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes. Material and methods Retrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81 diabetic patients diagnosed of colon cancer matched with 79 non-diabetic colon cancer patients. The impact of streptozotocin-induced diabetes on the growth of colon cancer xenografts was studied in mice. Results The incidence of DM in 1,137 patients with colorectal cancer was 16%. The diabetic colon cancer cases and non-diabetic colon cancer controls were well matched for demographic and clinical variables. The ECOG Scale Performance Status was higher (worse) in diabetics (ECOG ≥1, 29.1% of controls vs 46.9% of diabetics, p = 0.02), but no significant differences were observed in tumor grade, adjuvant therapy, tumor site, lymphovascular invasion, stage, recurrence, death or cancer-related death. Moreover, no differences in tumor variables were observed between patients treated or not with metformin. In the xenograft model, tumor growth and histopathological characteristics did not differ between diabetic and nondiabetic animals. Conclusion Our findings point towards a mild or negligible effect of the diabetes environment on colon cancer behavior, once cancer has already developed.